White-Wilson Association, P.a.

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

WHITE-WILSON ASSOCIATION, P.A.

Practice address

999 Mar Walt Dr
Fort Walton Beach, FL 32547-6758

Phone

(850) 863-8150

Fax

(850) 863-4152

NPI assigned

Mar 4, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Alan L Gieseman

Title

Ceo

Phone

(850) 863-8150

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• White-Wilson Medical Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646352000000",
    "number": "1831846336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8150",
            "fax_number": "850-863-4152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476758",
            "telephone_number": "850-863-8150",
            "fax_number": "850-863-4152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE-WILSON ASSOCIATION, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-04",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A",
        "authorized_official_last_name": "GIESEMAN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-863-8150"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "99017",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "059722800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White-Wilson Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donald William Whitaker, M.D
• White Sands Chiropractic Clinic Inc
• White Sands Integrative Medical, Inc.
• White Sands Physical Therapy Inc
• White Sands Podiatry LLC
• White-Wilson Medical Center PA
• White-Wilson Medical Center, P.a.
• White-Wilson Medical Center, P.a.
• Devin Michael White
• Kristina Maria White, M.ED; LMFT

• Multi-Specialty Clinic/Center in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.